Individual
DR. BEHROUZ MADANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13540 17TH ST, DADE CITY, FL 33525-5244
(352) 567-1411
(352) 567-6391
Mailing address
PO BOX 1177, DADE CITY, FL 33526-1177
(352) 521-1569
(352) 521-1579
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME26731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279121800
—
FL
01
—
51076
BCBS
FL
Enumeration date
05/24/2005
Last updated
02/23/2011
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